Woodleigh Rest Home Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to admission to the service. The registered manager said they visited people who were being admitted from their own homes to carry out the assessment. However, they did not always visit people who were coming in from hospital, relying instead on the assessment provided by hospital staff.

People and relatives were not always involved in the planning and reviewing of their care. Care plans were not always in place for people's needs. For example, 2 people had catheters, but there was no guidance for staff on catheter care in their risk assessments or care plans. Another person’s care plan did not provide guidance for staff on techniques to use when they became distressed or agitated.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

We found examples when the service had failed to adhere to best practice guidance and therefore standards of care and people’s experiences fell below what was expected. We observed people who required specialised diets were not always provided with them. For example, 1 person required a fortified diet and fluids. Our discussions with staff showed this was not being provided. Information displayed in the kitchen regarding individual dietary requirements was not up to date or accurate. No food or fluid charts were in place to monitor people’s intake. Some staff were recording fluid intake on paper towels in people’s rooms. Records also showed people were not being offered sufficient fluids. For example, over a 3-day period, 1 person’s fluid intake was 150mls or less a day. Adults typically require between 1200mls and 2000mls per day. This placed the person at risk of dehydration.

People gave positive feedback about the food and drink provided. Comments included, “The food is excellent. I get 2 choices” and “I enjoy the food. I get what I like for breakfast and there’s plenty to eat at mealtimes.” However, 1 relative raised concerns about the lack of support from staff in assisting their family member with meals.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Staff knew how to make referrals to health professionals, and we did not receive any negative feedback regarding the effectiveness of teamwork with external services.

However, communication between staff about people’s needs and changes was not always effective. Not all staff on shift were present for the handover which placed people at risk of not receiving the care they required. Care records were not always accurate which meant there was a risk when information was shared it was not accurate or fully complete.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and relatives did not raise any concerns about accessing health care support. One relative told us, “The district nurse comes in and the doctor does a ward round every week. [Family member] has all the support they need here.”

Care records showed input from health care professionals including the GP, district nurse and dietician.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Effective processes were not always in place to monitor people’s care and treatment. People’s outcomes were not monitored effectively as there was poor oversight of care records and people’s needs. Care plans were not always up to date or fully reflective of people’s current needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

A list was maintained of DoLS authorisations and records we checked showed conditions were being met.

However, where people lacked capacity, the principles of the MCA were not always followed. Capacity assessments were not always completed and, where people lacked capacity, best interest assessments were not always in place for relevant areas.